Referrals to Dietetic Service From Care Homes

What was the issue you were addressing or working on?

To continue to provide safe, effective person centred care by standardising and improving the quality and appropriateness of referrals for care home residents received into the Department.


What you did?

The Dietetic Domiciliary Audit 2011 highlighted that 41.5% of domiciliary visits carried out by Dietitians are for residents in care homes.  From July 2011 – June 2012 there were 755 new patients seen and 4086 patient reviews carried out in care homes.

The referral system was varied with a lack of standardisation which often meant that the information provided was either inadequate or not effectively communicated, making the appropriateness of the referral difficult to judge.  A proportion of referrals may be avoidable through early identification of risk of malnutrition and the implementation of the appropriate ‘food first’ principles.

A short life working group was brought together with the overall aim to continue to provide safe, effective person centred care by standardising and improving the quality and appropriateness of referrals received into the Department.  A report was taken to Care Home Managers Forum and agreed that this was a feasible project to take forward for Care Homes.

The following have been developed:

  • Nutrition Care Pathway for Care Homes
  • Dietetic Referral Guidance and referral form in care homes allowing directly refer patients rather than having to ask GP to refer

Through Change Fund money, there is a nutrition education training programme being delivered to care homes within Ayrshire and Arran.  This programme to date has been educating care home staff members on:

  • Identifying those at risk of malnutrition using the Malnutrition Universal Screening Tool (MUST)
  • Implementing the ‘food first’ principles when a risk of malnutrition is detected
  • The different varieties of oral nutrition support products available and ways to
  • encourage compliance

An education training pack has been developed and will be issued to each care home.


What were the outcomes - benefits or otherwise?

The new referral paperwork has been piloted in a number of Care Homes with positive feedback and will be rolled out to all care homes from October 2013. The referral pathway will be audited at 6 months post implementation.

Perceived benefits would be to provide safe, effective person centred care by  improving the quality and appropriateness of referrals for care home residents received into the Department thus maximising Dietetic resources.


Contacts - to find out more

June Milligan  June.milligan@aaaht.scot.nhs.uk 01294323535